| NPI | 1710221197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY WIGGEN Practice Manager 828-595-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2014-08-27 |